Provider Demographics
NPI:1013133800
Name:CURT ANDRE OD INCORPORATED
Entity Type:Organization
Organization Name:CURT ANDRE OD INCORPORATED
Other - Org Name:ANDRE HARTMAN & MEDINA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NATASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRAHIC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-632-2411
Mailing Address - Street 1:711 E HAWKEYE AVE
Mailing Address - Street 2:#1
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95380-7505
Mailing Address - Country:US
Mailing Address - Phone:209-632-2411
Mailing Address - Fax:209-632-9019
Practice Address - Street 1:711 E HAWKEYE AVE
Practice Address - Street 2:STE 1
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95380-7505
Practice Address - Country:US
Practice Address - Phone:209-632-2411
Practice Address - Fax:209-632-9019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2016-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6157T152W00000X
CA9253T152W00000X
CA13047T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0092530Medicaid
CASD0130470Medicaid
CASD0061570Medicaid
CASD0061570Medicaid
CASD0130470Medicaid
CAU11221Medicare UPIN
CASD0092530Medicaid
CA0824790001Medicare NSC
CASD0092530Medicare ID - Type Unspecified